Cost of mri scan?

Question

would blue cross/blue shield medical insurance possibly cover the cost of an mri scan?

just trying to figure out whether i'll be able to get it done or not...thanks!

Answer 1

They might, they might not.

MRI scans are really expensive so insurance companies are not exactly enthusiastic about covering them.

And recently, so many people have been requesting MRI scans that insurance companies are turning down a large number of them, even if they're necessary.

Take me, for example. I had an extra rib and if it was not taken out, I would die from anuerisms and the like. I needed an MRI scan before my surgery but my insurance company would not agree to cover it! So we appealed it about 3 times before they finally agreed to pay for it.

So my advice is, just request and MRI and if they decline it, keep appealing it. It may seem like a lot of work after a while but your health is worth it.

Hopefully blue cross/blue shield is better than Aetna HMO..

Answer 2

They will cover it as long as there is a medical necessity for it. But it will be paid according to your benefits-so the cost will be applied toward any unmet deductible and co-insurance.

Best to contact BX/BS and ask if you don't know what those amounts are....

Answer 3

First, it needs to be ordered by a doctor.  Make an appointment with your primary care doctor, pay the copay and ask them for an order for the MRI.  He'll do a quick exam and write an order for one if necessary.  If you don't get the MRI ordered by a doctor, there's absolutely NO chance that the insurance will pay for it.

Usually, the doctor's staff will give a call to your insurance company to make sure to schedule it in an area that is covered by your insurance.  I always call my insurance to double check.  Just call the 800 number on the back of your card and let them know you're checking benefits.  Ask if the MRI is covered and if the facility that you are having it at is a provider with the insurance.

Depending on your benefits, you may need to meet a deductible and then the MRI is covered at 80% or so.  I just had a knee MRI and they billed the insurance $400 for it.  If you have a plan that is more like an HMO, you may be covered at 100% or may have a copay.  Mine is $50.  

Call the insurance and go see a doctor to get an order!